Birth, Bureaucracy & the US Health Care System

My wife is recovering from the biggest change in her life so far, and quite possibly ever. Having a baby. Yes, its big for me too but its bigger for her. I guess that justifies the paper work? What about how birth is viewed by “the system” here in the US? Is it medical intervention or a natural process? Have we lost our way? And would a Public Healthcare option be more bureaucratic or the same?

It’s a real shame that my wife has to deal with the bureaucracy that is being kicked up by the Private Health system in this country so soon after giving birth. We’re under no illusions that Public Health wouldn’t have its own bureaucratic hoops. The situation we’re still dealing with after several weeks is that a certain signature is required on certain forms for the private company managing her medical leave, Matrix Absence Management (MAM). I’m of course handling as much as possible for her.

It’s not even about health care

This “form requirement” isn’t even the health care itself, its a part of the Private Health System Apparatus, if you will. The bureaucracy that exists to manage these things for companies providing family related medical leave. And for the record my wife’s company gives great health, and infant care leave benefits. It makes sense that they outsource this workload and all the paperwork that comes with it. I certainly would!

What forms? What signatures?

For my wife’s “medical leave” (time off after having a baby) to be approved MAM need a “licensed physician” to sign off on the paper work. They can’t accept a midwife. Incidentally the legality of this requirement is allegedly questionable, according to the midwives. Somehow this required my wife being called numerous times and resulted in me passing messages back and forth between the midwives and MAM. This whole process shows how the system views birth and the resulting administration, paper work, and back and forth wrangling that has sprung up to make money out of it. I’m not saying there is anything wrong with making money. It would certainly seem that the bureaucracy in place seems to be having coordination issues with our Swedish Ballard midwifery practice, who incidentally do have surgeons on hand both for birth related support and for such official and/or bureaucracy related items. But hey, that’s what organizations (public and private), systems, and thus bureaucracies bring with them. Right?

So would it be that much worse with a Public Health option?

Accusations that anything/everything run by the government brings with it bureaucracy and the implication that private companies do not simply is not true. Don’t get me wrong I don’t have a problem with private enterprise. I also don’t have a problem with the government. Both in necessary measure. I also have equal issues with both. Again, in equal parts. I’d hazard a guess that a Public Health Care Option in the US would have bureaucracy and paper work on a par with what is told in this tale. Today’s Private options certainly don’t eliminate it. And its possible that like in the UK there may be less paperwork as you’re not having to involve so many entities.

How does the US Health care system view birth? Adding to the story so far that our insurance viewed the fairly routine birth as a “Surgery” with a ~$4,000 price tag (update: additional costs of over $16,000 included items such as hospital stay) it seems that the system views it as a a medical “issue”, intervention or corrective care. I’m sure it often becomes the later. However is it that fundamentally and thus how should it be treated and handled?

Incidentally the aforementioned insurance is something that we are very appreciative and grateful to have through my job. Living in the US that is very important.

What is “Birth” any way?

The interesting thing is that birth existed before medicine, doctors and surgery. Don’t get me wrong. Medical professions are a monumental help. They make this intense life experience that much more easy to deal with. Especially when they are great and not pushing drugs when (not necessary). For example the nurses when my son was born were professional, effective, caring and truly amazing. As was the midwife – very skilled and talented. Doctors too can help enormously, if they are delivering. In particular they are critical when things go wrong or in the delivery of the baby and the normal human process goes wrong and requires intervention. Birth is not something that a woman does every day. Is it not at its heart a natural human bodily process developed over millions of years of evolution? And as such shouldn’t we treat it that way?

As for the paperwork? Well, we have to that in context. It may raise some interesting questions about this subject but if that’s the worst of our worries we should count ourselves lucky, take a big step back, nice deep breath and have a long hard look at the big picture.

I’ll close on an interesting question that came to me at lunch today: “In a truly free society wouldn’t there be a Public Health option along side the Private one to choose from?”. Hey, I’m just saying… 🙂


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